Stomach Ulcers: What They Are, How to AvoidThem, and Strategies to Fight Them

Part 1: Symptoms and Causes

The classic symptoms are all too familiar for those of us who battle their existence: a gnawing stomach pain that strikes a few hours after a meal, at night when we lay down to sleep, or in the early morning hours. Though once associated with stress, stomach ulcers are more the product of lifestyle and the side effects of medications.

Surprisingly, certain stomach bacteria can also cause ulcers. I say surprisingly because until recently it was believed that bacteria could not survive in the stomach, since it was a highly acidic environment. But, in 1982, research by Australian pathologist Robin Warren proved that patients with chronic ulcers had colonies of bacteria living in their stomach at the same time.

That finding was contradictory to the prevailing mindset that ulcers were not treatable. The best anyone could hope for was to try and effectively manage them: antacids, bland foods, and reducing stress were usually prescribed. But bacteria, if truly a culprit, could effectively be treated and cured by using antibiotics.

While this opened new doors to possible treatments for patients with ulcers, Warren’s findings were not taken seriously. Frustrated, Warren teamed up with Barry Marshall, a researcher at the University of Western Australia. They worked together to identify the particular bacterium in question. It was named “Helicobacter pylori.”

In a daring display of faith in his findings, Warren infected himself with the bacteria, creating stomach ulcers. He then effectively treated himself with the use of antibiotics. Long held erroneous beliefs about ulcers slowly began to dissolve. In 2005, Warren and Marshall were finally awarded the Nobel Prize in medicine for their groundbreaking work in the treatment of stomach ulcers.

Just what is an ulcer? While the term “ulcer” can refer to any type of sore or lesion that won’t heal, gastric ulcers are crater-like sores that develop in the mucous membrane, or lining of the stomach. Sometimes a sore caused by bacteria or drugs develops first, and is exposed to stomach acid that causes further damage. Other times underlying sensitive tissues become exposed to digestive juices, and are eaten away, causing the sores.

Either way, the stomach breaks down its own tissues and digests them. Left untreated, ulcers can grow deep enough to perforate the lining, causing internal bleeding.

Another type of ulcer and the most common, duodenal ulcers develop not within the stomach, but the first 12-inches of the small intestine. Untreated, they can block food from the stomach from entering the intestine. When this happens, the person usually begins to vomit food mixed with blood.

About 1 in 10 Americans develop at least one ulcer during their lifetime. Approximately 5 million people are affected by ulcers each year, 40,000 of which require surgery because of persistent problems. And nearly 6,000 people die each year from ulcer-related complications.

While ulcers are neither contagious nor cancerous, the ulcer causing bacterium can be transmitted through contaminated food and water. It is also possible for a stomach ulcer to become malignant, or to develop within an existing cancer. Duodenal ulcers, on the other hand, are almost always benign.

Ulcer sores can be tiny, or cover an area one-fourth inch to two inches in diameter. Both types of ulcers can be life threatening; prompt medical attention is critical. When caught early, non-surgical treatment is effective about 95-percent of the time.

Many persons blame hot spicy foods for causing ulcers, but that is not a proven fact. While spicy foods may agitate an existing ulcer, scientists believe other factors are culprits in the actual development of them.

According to Marvin Schuster, M.D., chief of the division of digestive diseases, and professor of medicine at Johns Hopkins University School of Medicine in Baltimore, cigarette smoking is one such factor. Not only is cigarette smoking a cause of ulcer formation, it can also inhibit effective treatment.

The overuse of non-steroidal anti-inflammatory drugs such as aspirin, naproxen, or ibuprofen can cause ulcers. Studies also reveal that nearly 85-percent of all stomach ulcers develop as a result of bacteria infection.

While caffeine, alcohol, and other lifestyle factors may also play a role in the development of ulcers, it is uncertain just how much of a role they play. Caffeine stimulates acid secretion in the stomach, and can aggravate an existing ulcer, and ulcers are more common in people who have cirrhosis of the liver  a disease linked to heavy alcohol consumption.

Symptoms of gastric and duodenal ulcers include a gnawing, burning pain in the abdomen between the breastbone and the navel. The pain can also radiate from the stomach to the back, and be dull or sharp. Other symptoms, although less common, are frequent belching, nausea, vomiting a substance that resembles coffee grounds, dizziness, feeling lethargic, poor appetite, dark stools, and loss of weight.

Risks for developing an ulcer include improper diet, irregular or skipped meals, smoking, excessive alcohol intake, and a family history of ulcers. Duodenal ulcers are found more frequently in persons with type “O” blood. Women are more likely to develop gastric ulcers, while men are more likely to develop the duodenal type.